What is Hospice Care?

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Hospice is a type of serious illness/end of life medical care that prioritizes the quality of the patient’s life. Hospice can be thought of as both a concept and a service. Conceptually, the goal of hospice is to help you stay comfortable while receiving treatment. While hospice teams are experts in treating pain, they also tend to other symptoms like stress and emotional pain. The treatment team typically consists of a medical director, nurse, and a social worker. Additional services, such as a chaplain, are available if requested. 

Medicare and other health insurance options have different eligibility rules for who can qualify for hospice care.  Many insurance plans pay for hospice care if the patient is only expected to live 6 months or less, while others may extend that to 12 months or less. Check with your health plan to learn about their eligibility requirements.

Where do patients receive hospice care?

For most people, hospice means care visits in their own home or nursing home. Hospice can also take place at a dedicated hospice facility or within a hospital. Patients within these facilities usually require closer monitoring or adjustment of medications.

Who pays for hospice?

Hospice is a benefit that’s paid for by Medicare, the Veterans Administration, and most private insurances. Some insurance plans may require co-pays or co-insurance.  There are also foundations that help individuals who are otherwise unable to pay for hospice. When someone is approved for hospice care, they are assigned a social worker who will assist with understanding these financial matters.

What is hospice not?

Hospice is not 24-hour nursing care. Unlike 24-hour care, hospice typically includes at-home nursing visits a few times a week, in addition to visits from a social worker depending on your needs. These visits can increase in frequency, as required. 

It is also not the same as palliative care. Palliative care is a medical specialty that focuses on patient comfort by treating the symptoms of an illness. While hospice care and palliative care share similar values when it comes to focusing on quality of life, palliative care allows the patient to pursue curative treatment.  Most hospice programs do not allow the patient to pursue a cure for their illness while receiving care, but some do allow this. Check with your health insurance company to understand their policy on hospice care. 

Can I still go to the hospital if I’m receiving hospice services?

Most patients receiving hospice care are not allowed to pursue curative treatment. For this reason, patients typically do not go to the hospital for additional treatment and going to the hospital may result in losing additional hospice care. If you receive inpatient care while receiving hospice through Medicare, the hospice team must make the arrangements to have you admitted. 

You should discuss this question and concern with your hospice care team. In an emergency when you may wish to visit the hospital, most hospice teams recommend contacting them prior to going. They are capable of performing most of the treatments the hospital would use while at home, including pain management and relief.

What does the hospice doctor do?

Every hospice program has a medical director who certifies that a patient can receive hospice services. This doctor works closely with the whole team of care providers, in addition to your primary physician (who remains a part of your treatment team), and is on call when needed.

Will I still receive care for my non-terminal conditions?

Yes – hospice care only covers your terminal illness and its related conditions, but you will still have coverage for and can receive treatment for your non-terminal conditions.

What happens if I live longer than 6 months?

In order to receive hospice care, two doctors must evaluate you and determine that you are terminally ill with less than six months to live. However, in the event that a hospice patient lives beyond six months, coverage will continue as long as the hospice doctor certifies that they remain terminal. If your health improves while on hospice, such as regaining appetite or mobility, your care team may determine that you no longer need services. However, if your condition later worsens, hospice will become available again.

How do I learn more about a specific hospice organization?

Hospices and the services they provide can vary between organizations. They can be nonprofit or for-profit, serve one or many communities, and be independent or connected with another hospital or health system.  Your primary care doctor should know what hospices serve your area, and you can also search online: http://www.nhpco.org/find-hospice.

Is hospice a service you'd be interested to receive at the end of life?
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